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Endocrine System

Thyroglossal fistula

Small, midline, and acquired fistula related to the thyroglossal duct with a crescentic skinfold above it

Small, midline, and acquired fistula related to the thyroglossal duct with a crescentic skinfold above it

  • It represents about 15 % of the cases. It is never congenital.
  • Lined by columnar epithelium, discharges mucus and is a site of recurrent infection.

Anatomy

Thyroglossal cyst locations:

Related to the thyroglossal duct
Thyroglossal Duct Cyst locations
Thyroid Clinic Sydney. (2016). Sistrunk Procedure for Thyroglossal Duct Cyst – Thyroid Clinic Sydney. [online] Available at: http://www.thyroid.com.au/sistrunk-procedure-for-thyroglossal-duct-cyst/ [Accessed 24 May 2017]
  • Subhyoid (M/C site)
  • On thyroid cartilage (2nd M/C site)
  • Suprahyoid
  • Beneath foramen caecum
  • Mouth floor

Clinical features

  • It moves up with swallowing and with protrusion of the tongue.
  • Hood sign: Opening of fistula is indrawn and overlaid by fold of skin
  • Semilunar sign: Peculiar crescentic appearance
Thyroglossal Fistula
Thyroglossal Fistula is an acquired fistula related to the thyroglossal duct. It represents about 15 % of the cases. It is never congenital. The opening is small, midline, and with a crescentic skinfold above it. It moves up with swallowing and with protrusion of the tongue. (a) Thyroglossal fistula with the tongue in place, (b) Upward movement of the fistulous opening with protrusion of the tongue | Themes, U. (2016). Swellings of the Neck. [online] Ento Key. Available at: https://entokey.com/swellings-of-the-neck/ [Accessed 24 May 2017]

Diagnosis

  • Radioisotope study
  • Fistulogram

Management

Sistrunk operation (prevents recurrence)

Excision of cyst + full tract up to foramen caecum + central part of hyoid bone

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